NUR 2356/MDC II Final Exam Study Guide/Chapter 11: Care of Patients with Fluid and Electrolyte Balance,100% CORRECT
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NUR 2356
NUR 2356/MDC II Final Exam Study Guide/Chapter 11: Care of Patients with Fluid and Electrolyte Balance
Hypervolemia
S/S: pitting edema, increased HR/BP/HR, distended neck and hand veins, weight gain, SOB, lung crackles, pale/cool skin, decreased lab values, alter LOC
Treatment: patient safety ...
nur 2356mdc ii final exam study guidechapter 11 care of patients with fluid and electrolyte balance
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NUR 2356/MDC II Final Exam Study Guide/Chapter 11: Care
of Patients with Fluid and Electrolyte Balance
Hypervolemia
S/S: pitting edema, increased HR/BP/HR, distended neck and hand veins, weight
gain, SOB, lung crackles, pale/cool skin, decreased lab values, alter LOC
Treatment: patient safety (assess every 2 hours for PE), assess for skin
breakdown (skin care), provide supplemental O2 and position patient in semi-
fowler’s to improve SOB, furosemide, fluid restriction, monitor daily weight
and output, restrict Na/low sodium diet (water follows)
Hypovolemia
S/S: increased HR, orthostatic hypotension (increased risk for falls), weak/thready
pulse, flattened neck/hand veins, increased RR, decreased turgor, warm/dry skin,
dry mucous membranes, fever, decreased urine and increased concentration,
increased lab values
Treatment: fluid replacement (monitor pulse rate/quality and urine output of 30
ml/hr. during rehydration), antidiarrheals, antiemetics, antipyretics
Calcium: Hypercalcemia
Causes: hyperparathyroidism/hyperthyroidism, dehydration, use of thiazide
diuretics, use of glucocorticoids, kidney failure, malignancy, excessive intake of
calcium or vitamin D
S/S: (EKG CHANGES FROM CLOT): cyanosis, pallor, EKG changes, increased risk for
blood clots, profound muscle weakness, decreased DTR, decreased
peristalsis/bowel sounds, constipation, kidney stone formation
Calcium: Hypocalcemia
Causes: lactose intolerance, Crohn’s disease, celiac disease, acute pancreatitis,
ESKD, diarrhea, wound drainage, alkalosis (hyperventilation), hyperproteinemia
S/S: (HYPERACTIVE CRAMPS): muscle spasms (“charley horses”), tetany,
hyperactive reflexes, + Trousseau’s and Chvostek’s signs, arrythmias,
weak/thready pulse, painful abdominal cramping, diarrhea, loss of bone density
(osteoporosis), brittle/fragile bones (may break with slight trauma), confusion
Normal Calcium (Ca+): 9.0-
,10.5mg/dL Potassium:
Hypokalemia
Causes: diuretics, alkalosis (hyperventilation), TPN, NPO, Cushing’s syndrome,
vomiting, wound drainage, prolonged NG suctioning, heat-induced/excessive
diaphoresis, corticosteroids, increased aldosterone
S/S: (SLOW, LOW, + LETHAL): low/shallow respirations, muscle weakness, reduced
DTR, leg cramps, limp muscles, lethal cardiac changes, low BP and HR, increased
urine output, decreased bowel sounds (constipation)
Normal Potassium (K+): 3.5-5.0 mEq/L
,Magnesium: Hypomagnesemia
S/S: (HYPERACTIVE TWITCHING/SEIZING): HTN, dysrhythmias, constipation,
hyperactive DTRs, involuntary movements, + Trousseau’s and Chvostek’s signs,
Torsade’s de Pointes, weak respirations
Normal Magnesium (Mg+): 1.8-
2.6 mEq/L Sodium:
Hyponatremia
S/S: (SALT LOSS): confusion, trouble concentrating, seizures, stupor, muscle
weakness/spasms, diminished DTRs, abdominal cramping, increased urine
output, loss of appetite, shallow respirations, orthostatic hypotension, diarrhea
Normal Sodium (Na+): 136-145 mEq/L
Chapter 12: Care of Patients with Problems of Acid-Base Balance
ABG Interpretation
1. Is the pH out of range? (in range and opposite direction-fully compensated; out
of range and opposite direction-partially compensated; same direction-
uncompensated)
2. Is the PaCO2 normal/out of range? (respiratory)
3. Is the HCO3 normal/out of range? (metabolic)
4. Match the one (PaCO2 or HCO3) that is the same as the pH. (acidosis or alkalosis)
5. Does the one that does not match/remains go in the opposite direction of pH?
(compensation)
6. Is PaO2 and O2 sat out of range? (hypoxemia)
pneumonia, in table below Respiratory Alkalosis/Metabolic
Alkalosis
Interpretation: hypocalcemia and hypokalemia, dizziness, twitching, tingling,
increased HR and RR Causes: in table below
Metabolic Alkalosis
Common Causes of Alkalosis
Increase of base components Oral ingestion of bases:
Antacids
, Common Causes of Acidosis
Metabolic Acidosis
Overproduction of Excessive oxidation
hydrogen ions of fatty acids:
Diabetic ketoacidosis
Starvation
Hypermeta
bolism:
Heavy
exercise
Seizure
activity
Fever
Hypoxia, ischemia
Excessive ingestion
of acids: Ethanol or
methanol
intoxication
Salicylate
intoxication
Under-elimination of Kidney failure
hydrogen ions
Underproduction of Kidney
bicarbonate failure
Pancreat
itis Liver
failure
Dehydra
tion
Over-elimination of Diarrhea
bicarbonate
Respiratory Acidosis
Under-elimination of Respiratory
hydrogen ions depression:
Anesthetics
Drugs (especially
opioids) Electrolyte
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